# MITCHELL M NISHIMOTO MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518435551
- **Authorized official:** MITCHELL NISHIMOTO (PRESIDENT)
- **Authorized official phone:** (818) 785-3889

## Contact information

- **Practice address:** 15243 VANOWEN ST STE 408, VAN NUYS, CA 91405-3658
- **Practice address phone:** (818) 785-3889
- **Practice address fax:** (818) 782-1227
- **Mailing address:** 15243 VANOWEN ST STE 406, VAN NUYS, CA 91405-3655
- **Mailing address phone:** (818) 785-3889
- **Mailing address fax:** (818) 782-1227

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2018
- **Last updated:** 11/07/2018